The association between Gulf War Illness and suicidal thoughts and behaviors among Gulf War Era Veterans.

The rate of death by suicide is elevated among Veterans of all eras. Chronic symptoms of pain, depression, and sleep disturbances are also common among Veterans, and these symptoms are associated with suicidal thoughts and behaviors. About 25% of the 697,000 Gulf War Era Veterans deployed to the Persian Gulf theater in 1990-1991 remain afflicted with chronic, unexplained symptoms known as Gulf War Illness (GWI). This study used data from a national sample of Gulf War Veterans (N = 1142) who completed a survey of demographic, military, and health information. Multivariable logistic regression models, controlling for confounding variables, tested for associations between deployment, a tri-level categorical variable of GWI (no GWI; moderate GWI; and severe GWI) and suicidal thoughts and behaviors. Deployment was not associated with any suicide related outcome. Moderate and severe GWI remained significantly associated with past year suicidal ideation (moderate GWI: aOR 3.94; 95% CI: 1.55-10.03; severe GWI: aOR 3.66; 95% CI: 1.31-10.20), but they were not associated with suicide attempts. Our findings suggest that the burden and negative impact of the chronic symptoms of GWI may play a role in the occurrence of suicidal ideation in Gulf War Veterans (GWV). Clinicians caring for GWVs should attend to both chronic symptoms, and the elevated risk of suicidal thoughts in this cohort.